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Review
. 2018 Oct;5(4):235-242.
doi: 10.1016/j.ajur.2018.06.007. Epub 2018 Jun 26.

Defining metabolic activity of nephrolithiasis - Appropriate evaluation and follow-up of stone formers

Daniel A Wollin  1 , Adam G Kaplan  1 , Glenn M Preminger  1 , Pietro Manuel Ferraro  2 , Antonio Nouvenne  3 , Andrea Tasca  4 , Emanuele Croppi  2 , Giovanni Gambaro  2 , Ita P Heilberg  5
Affiliations
Review

Defining metabolic activity of nephrolithiasis - Appropriate evaluation and follow-up of stone formers

Daniel A Wollin et al. Asian J Urol. 2018 Oct.

Abstract

Considering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologic follow-up. A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis. Both single and recurrent stone formers share many similarities in metabolic profiles. The study group determined that based on an assessment of risk for stone recurrence and metabolic activity, single and recurrent stone formers should be evaluated comprehensively, including two 24 h urine studies on a random diet. Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence. Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient, the risk of chronic kidney disease and the risk of osteoporosis/osteopenia. A standard scheme includes a baseline metabolic profile, a repeat study 3-6 months after initiation of treatment, and then yearly when stable, with abdominal imaging obtained every 1-2 years.

Keywords: Follow-up; Medical management; Metabolic evaluation; Urolithiasis.

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Figures

Figure 1
Figure 1
Consensus algorithm for stone evaluation and follow-up.
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References

    1. Chandhoke P.S. Evaluation of the recurrent stone former. Urol Clin N Am. 2007;34:315–322. - PubMed
    1. Strauss A.L., Coe F.L., Parks J.H. Formation of a single calcium stone of renal origin: clinical and laboratory characteristics of patients. Arch Intern Med. 1982;142:504–507. - PubMed
    1. Pak C. Should patients with single renal stone occurrence undergo diagnostic evaluation? J Urol. 1982;127:855–858. - PubMed
    1. Eisner B.H., Sheth S., Dretler S.P., Herrick B., Pais V.M. Abnormalities of 24-h urine composition in first-time and recurrent stone-formers. Urology. 2012;80:776–779. - PubMed
    1. Strauss A.L., Coe F.L., Deutsch L., Parks J.H. Factors that predict relapse of calcium nephrolithiasis during treatment. Am J Med. 1982;72:17–25. - PubMed

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